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be admitted members of the Congress on applica-tion to the secretary. The arrangements fortravelling and hotel accommodation are in thehands of Messrs. Thos. Cook and Son, LudgateCircus, E.C., to whom application should be made.

A CENTRAL INSTITUTE FOR CHILD WELFARE.

A GREAT gift is announced in the sixth annualreport of the Carnegie United Kingdom Trust,which has just appeared. The Central Council ofInfant and Child Welfare, in which, through theefforts of Sir Arthur Stanley, chairman of theBritish Red Cross Society, eleven of the principalwelfare societies in London are united, has qualifiedfor the grant of 40,000 offered by the CarnegieTrustees for a central institute. Since the offerwas originally made to the Council, the Red CrossSociety has proposed to erect or purchase a largebuilding to house (a) V.A.D. and Red Cross work;(b) a tuberculosis centre ; (c) a college of nursing,besides the central welfare work ; and the CarnegieTrustees have agreed to this proposal provided

that a distinct wing is used for the child-welfareinstitute. No building has yet been acquired, butthe Central Council has obtained temporary pre-mises in which the work of the central institute isbeing commenced. Progress has been made in

regard to a similar central institute in Edinburgh,but arrangements have not gone as far as inLondon. The report of the Carnegie Trust statesthat the policy of giving grants for Church organsis being discontinued, the trustees evidently beingmindful of the injunction to them of the latefounder: " Let my Trustees therefore ask them-selves from time to time, from age to age, how theycan best help man in his glorious ascent onwardand upward, and to this end devote the fund."

THE UNIFICATION OF MEDICAL SERVICES INRURAL AREAS.

IN his annual report for 1918 as county medicalofficer of health for Gloucestershire Dr. J. MiddletonMartin summarises the scheme which has beenadopted by that county council for the extension ofmedical services in the more rural districts. Theventure has been referred to more than once in themedical press, and in view of its very practicalbearing on the development of a unified service ofmedical treatment no excuse is necessary for re-

sketching the outlines of the scheme. Almost everycounty with a considerable rural population has feltthe difficulties and dangers involved in a possiblemultiplication of clinics, each for an individual

purpose. In Gloucestershire the problem wasmade the more urgent by the quick succession ofmedical needs which came knocking at the countydoor for satisfaction-treatment of the tuberculous,of the venereal case, of the school child; the careof ex-Service men, and of mothers, infants, andyoung children. The county, after negotiationswith the governing bodies of general and cottagehospitals and with other interested parties, hasevolved a bold scheme for the provision of some 50out-stations, or out-patient clinics. These will besomewhat on the lines of existing tuberculosisdispensaries, with consulting room, waiting room,and dressing rooms, and will be so distributed thatone will be accessible within a radius of aboutthree miles of every patient. At these clinics out-patient treatment will be available for all thespecial classes of persons for whom provision is

now, or will in the future be, made out of thepublic purse. The usual medical attendantswill be the local practitioners, assisted by the

specialist staffs of the hospitals, while the

specialist staffs of the county council, as regardstuberculosis and venereal disease, will alsouse the clinics for their particular work. Thecentres will be available for out-patient treat-ment under the Insurance Acts, while school caseswill receive intermediate treatment by nurses,and ex-Service men by masseurs. The countycouncil will provide and equip the clinics, whichwill, so far as possible, be in connexion with thecottage hospitals. The scheme will be controlledby a joint committee of the county council and ofthe general hospitals, and this committee will selectthe staffs for the various centres.The growth and practical working of this scheme

should be a matter of interest to the wholemedical profession, and not least to the responsibleofficers of counties in which the same problemis becoming constantly more pressing. Thoseauthorities who are slower in taking up the runningwill do well not to spoil the course for a later startby committing themselves meanwhile to bricksand mortar without very serious thought. Theimmediate moral appears to be, not to buildpremises for individual medical services if thiscan in any way be avoided. If premises cannot berented, and building is after all found necessary,then it should be considered carefully whetherthe proposed site and type of building are such aswill meet not only the immediate needs of theauthority, but also the ultimate requirements ofthe neighbourhood ; and, further, whether the siteand the building are likely to commend themselvesto the members of the medical profession who, itis to be hoped, will cooperate with the publicauthority in some such joint scheme as has beenevolved in Gloucestershire.

MOTOR FUELS: MEDICAL AND PUBLICCONSIDERATIONS.

THE report issued by the Board of Trade thisweek dealing with the costs, prices, and profits atall stages in respect of petrol, benzol, and othermotor fuels obviously concerns the medical man.The report has been drawn up by a well-chosensubcommittee, and its conclusions call for veryserious attention. At the outset it is shownthat motor fuel is rapidly becoming of vital import-ance to practically every industry, not excludingagriculture, in all civilised countries. Thereforethe concentration of control over the price anddisposition of motor fuel in the hands of twoenormously powerful capitalistic combines, practi-cally world-wide in their scope, is regarded as

constituting so dangerous a power, if it happensto be improperly used, that the governmentsof the world are asked imperatively to giveattention to the situation. The demand formotor fuels tends to outstrip the world’s presentsupply, and there is grave danger of a per-manent famine in motor spirit, even at fabulousprices. We seem to be very slow in develop-ing the possibilities of other fuels for usein motor service, and we are not surprisedto find that the Committee is insistent thatwork should be begun at once to produce homeor Empire fuel. Power alcohol, it concludes, isthe only potentially unlimited source of supply,and it is urged that the Government should