1378 UNITED STATES OF AMERICA.

throughout France, and with the extension of specificvaccination against these diseases.

Measles, Scarlet Fever, and Cerebro-spinal Fever.-Although measles occurred more frequently in 1930than in 1929, reports from all over the countryindicated that it was very benign. Scarlet fevershowed no change from 1929. It is curious that whilethere were only some 14,000 cases in France through-out the whole of 1930, there were as many as 35,000notified in England in the first quarter only of thisyear. Cerebro-spinal fever seems to be on the wanein France, only 412 cases having been notified in1930 as compared with 467 in 1929..PHARMACEUTICAL PREPARATIONS FOR INMATES OF

PRISONS.

The, ingenuity of practitioners is often taxed

:beyond breaking-point by the samples of pharma-ceutical products flung at them. Try them on thedog ? Or let them accumulate in cupboards ?The latter alternative certainly follows the lines of.least resistance. Perhaps this is why the cupboardhabit is so universal. But examined closely and.critically, it seems a negative, defeatist, and cowardlyreaction on the part of the recipients of these samples.to the donors thereof. What seems to be a very.sensible escape from this impasse has recently beendevised by a philanthropic body of doctors who have,grouped themselves under the title of L’Oeuvre,d’approvisionnement Medical des Prisons " (A.M.P.).This body, having noticed that prison dispensaries.are often short of drugs, while private medical prac-titioners suffer from a surfeit of them, has devised a.system for diverting this surfeit to the prisons. Theowners of superfluous samples are requested to sendthem to a central depot in the rue Cambaceres inParis. To facilitate their classification and prescrip-tion, they are asked to label them according to theorgans or diseases for which their makers intended.them. Thus one lot of samples should be labelled" heart and circulation," another " respiratory:apparatus," another " rheumatism, gout, diabetes,".another " women," another " nerves and aches andpains," another " fevers and infections," another" tonics," and so on. From the humanitarian pointof view this scheme seems excellent, and the namesof its sponsors are in themselves a guarantee of itsphilanthropic motive. Whatever individual sceptics ,,

:may think of the therapeutic value of the average ’,,proprietary pharmaceutical preparation, judged bystrictly pharmacological standards, it is impossibleto overrate the psychic value of " something in a:bottle." The prisoner who in the past has been givenno remedy for his aches and pains, must have oftenbeen tempted to think he was neglected simply.because he was a prisoner and not because the prison.medicine cupboard was bare.

UNITED STATES OF AMERICA.

,(FROM AN OCCASIONAL CORRESPONDENT.)

SANITATION AND UNEMPLOYMENT.

A COMMITTEE of sanitary engineers representing the- sanitary engineering divisions of State public healthdepartments has drawn up a memorandum on therelation of unemployment relief to engineeringprojects. Investigation has shown that projectsfor the purification and protection of water-suppliesand for the installation and operation of sewerage- works are suffering as the result of the depression.

The committee points out that such a result is creatinga mortgage on the health of future generations. Reliefcommittees handling funds subscribed voluntarilyby the general public will wish to use these funds asfar as possible to create employment rather than tosupport families in idleness. What better employ-ment could be found than work which will improve thehealth and environment of future generations The committee recommends that surveys be made inthe several States of need for " the improvement ofwater-supplies and distributing systems, works for thecollection and disposal of sewage, refuse, garbage, andother municipal wastes, malaria and mosquitocontrol, rural sanitation, and reclamation of waste orwet lands for recreation and other useful purposes."

This memorandum has been adopted by theConference of State Sanitary Engineers, by the

engineering section of the American Public HealthAssociation, and by the Association’s governingcouncil.

ENTERIC IN MONTREAL.

As an example of what may happen as a resultof relaxing standards of sanitation I may quotea recent report 1 in the devastating epidemic of

typhoid fever in Montreal in 1927. It was shown thatmilk, cream, and ice-cream were the common articlesof food in the dietaries of the sick. The preponderanceof cases was amongst the young. Cases were scarceor absent in areas not supplied by the MontrealDairy Company and its associate the National DairyCompany. The milk supplied by these companieswas pasteurised milk. The story of how this milkcame to be responsible for the most extensive epidemicof typhoid fever recorded in modern times is a storyof inadequate supervision and control of the pasteuris-ing plant. The methodical procedure of the investiga-tion and the graphic illustrations of the methods

employed constitute a model text of thoroughepidemiological research. The investigation is

published with the approval of the Director of theProvincial Bureau of Health at Quebec.

SEWAGE IN THE GREAT LAKES.

A plea for more adequate control of sewage andwastes discharged into the Great Lakes is entered

by a Cleveland engineer in the Scientific Monthly.2An important investigation was made in 1913-14as a result of a treaty between Great Britain and theUnited States, the scope of the inquiry being todetermine " to what extent and by what causes and inwhat localities have the boundary waters between theUnited States and Canada been polluted so as to beinjurious to public health and unfit for domestic andother uses." This investigation confirmed the workof previous if less important studies that the lakesare dangerously polluted with sewage along shoresopposite to large centres of population. Were itnot for the irregular diffusion of wastes by surfaceand sub-surface currents, the natural processes ofpurification would have a better chance to protectwater-supplies. Onshore winds have a tendency todrive surface currents shoreward, and the waterreturns as an undertow to the body of the lake.Ordinary measures of water purification are insufficientprotection against such risks of heavy contamination.Adequate treatment of sewage and trade wastesis called for not only by the above consideration,but also that shore waters used for bathing may be

1 Pease, H. D. : An investigation of Epidemic Typhoid Feverin Montreal in 1927. Pease Laboratories Inc., New York, 1931.

2 Ellius, J. W.: Water Purification and Sewage Disposal in theGreat Lakes. Scientific Monthly, November, 1931, p. 423.

1379IRELAND.-MEDIOINE AND THE LAW.

protected from floating sewage solids and from oilsand grease. Even the danger of contamination bypassing vessels is not as negligible as it was oncebelieved to be. The entry to the lakes of ships fromforeign ports introduces danger of such infection ascholera unless the quarantine regulations and therules prohibiting discharge of sewage are rigidlyenforced.

POLIOMYRLITIS AND SERUM.

The appeal, referred to in a former letter,3 madeby the New York State Department of Health forimmune blood to be used in the treatment of polio-myelitis has met with remarkable success. Over 1100

persons responded and actually 1011 were bled betweenJuly 27th and Oct. 5th. Eighty-seven of these werebled twice and many others volunteered to be bled asecond time. The department has now a largereserve list of donors and has been able fully to meetthe emergency created by the recent epidemic.

IRELAND.

(FROM OUR OWN CORRESPONDENT.)

THE HOQPITALS SWEEPSTAKES.

THE Hospitals Trust has now passed to its bankersa sum of .El, 12 4,70 for payment of prizes on theManchester November Handicap. A sum of 739,754is available for the hospitals. Of this one-thirdhas been paid to the Minister for Local Governmentand Public Health for distribution to rate-supportedinstitutions. The remainder-a little less than half amillion-will be divided among 44 voluntary hos-pitals in such proportion as the Minister for Justiceshall determine after he has received the advice of hiscommittees of reference. Preparations for the nextsweepstake-on the Grand National-are alreadywell advanced. Forty-eight voluntary hospitals havebeen admitted as participants, the newcomers ’,being the Rotunda Hospital, Mercer’s Hospital,Cliftonville Convalescent Home, Cork, and St. Patrick’s IIncurable Hospital, Cork. I

It is probable that a suggestion will soon be putforward in concrete form to provide that a certainproportion of the Hospital Fund accruing from futuresweepstakes should be allocated to medical research.At present there is no public provision for medical Iresearch in Ireland, and attempts to obtain moneyfrom various sources have failed. It is pointed outthat a small percentage of the Hospital Fund would Iprovide amply for research for the next few years, i

and might even provide a capital, the income ofwhich, when sweepstakes are no more, would givea subsidy to help research in the future. The ResearchFund would presumably be under the control ofthe Minister for Local Government and Public IHealth, who should be assisted in its administrationby a small council appointed for the purpose.

A NEW CHAIR IN UNIVERSITY COLLEGE, DUBLIN. IThe Senate of the National University of Ireland I’I

has established a chair of biochemistry and pharma-cology in University College, Dublin, and has appointed IDr. Edward J. Conway thereto. Dr. Conway has Idone important research work in the last few years, Ifdealing mainly with the secretory functions of the iikidney. He is a graduate in medicine, and a Doctor iof Science, of the National University. I

3 THE LANCET, Sept. 5th, p. 550.

MEDICINE AND THE LAW.

" Osteopathic Physician and Surgeon."SECTION 40 of the Medical Act makes anyone

liable to a fine not exceeding 20 who wilfully and.falsely pretends to be or takes or uses the name ortitle of a physician or surgeon or any name or descrip-tion implying that he is registered under the Act,.or that he is recognised by law as a physician orsurgeon. If the magistrate at the Marylebonepolice-court is right, the section has no terrors foranyone who, in describing himself as physician orsurgeon, prefixes the qualifying word " osteopathic."’Prof. A. E. Shakesby, a bone-setter and osteopath,.practising at Dorset-square, was summoned at thatcourt on Dec. 9th for taking the description " osteo-pathic physician and surgeon." Mr. Bingley, themagistrate, held that this was not an offence againstthe section ; the defendant had not described himselfas a

"

physician or surgeon " but had merely amplified-his profession of bone-setting. A case is to be statedfor the opinion of a higher court.The issue presumably is a question of fact-what

would the Profesor’s description be taken to meanby an ordinary person ? Would it suggest to sucha person that the Professor was a duly qualified andregistered medical practitioner or would the Professor’sdescription sufficiently make clear that no such claimwas made t When the Bengali student writes afterhis name " failed B.A.," ordinary persons do notunderstand him to be describing himself as a Bachelor.of Arts. It must be in some similarly restrictive sensethat Mr. Bingley interprets Prof. Shakesby’s descrip-tion " osteopathic physician and surgeon." Somepeople may be surprised that a not duly qualifiedpractitioner, who adopts the title " physician andsurgeon " in any form or context, fails to realisethat he may be creating the impression that he isduly qualified. If a description is ambiguous, it

ought not to be used. The whole purpose of theMedical Act is to enable the public to distinguishpersons who are duly qualified from persons who,are not.

Court Martial Conviction for Dentists ActOffence.

I It is odd to find an offence against the Dentists.Act being punished by a court-martial. On Dec. llth,,a private in the Army Dental Corps, attached to..No. 12 Company, R.A.M.C., was found guilty bya district court-martial at Woolwich of havingpractised dentistry without being registered in theDentists Register, and of having converted to hisown use a sum of money entrusted to him by anothersoldier for the purpose of obtaining artificial teeth..The accused was sentenced to 56 days’ imprisonment,with hard labour and dismissal from the Army withignominy. A soldier, being also a citizen, is subject,to the civil as well as to the military law. A court--martial can try and punish him for offences committedagainst the ordinary law in England, except for a few-grave offences such as treason, murder, manslaughter,.and rape.

ENLARGEMENT OF CHESTERFIELD HOSPITAL.--Last week the Duke of Devonshire opened a new wardof 31 beds and other additions to this institution which.have cost 222,000. The ward is named after the late Mr.Thomas Murphy, of Chesterfield, who bequeathed 10,000.to the hospital. The buildings include ophthalmic,nose, throat, and ear departments, a theatre, and a

laboratory.